Americans are more than five times more likely to skip medication doses or not fill prescriptions due to cost than peers in the United Kingdom or Switzerland. U.S. patients are twice as likely as Canadians to avoid medicines due to cost. And, compared with health citizens in France, U.S. consumers are ten-times more likely to be non-adherent to prescription medications due to cost.

The pill-bar chart illustrates the big difference between U.S. patients and health citizens living in other wealthy countries including Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the UK. Dr. Steven Morgan, professor of health policy at the University of British Columbia, and student researcher Augustine Lee, studied self-reported cost-related non-adherence (CRNA) patterns across the eleven countries using data from The Commonwealth Fund’s 2014 International Health Policy Survey of Older Adults, which focused on people aged 55 years and over. Among the 11 nations, 9 provide health citizens comprehensive universal health care coverage which includes prescription drug coverage. Canada (the tenth country) covers health care universally, but residents may not have access to drug coverage which can vary by patient age, occupation, income, and province of residence.

Among the eleven developed countries studied, the U.S. is the only one which does not offer universal coverage for healthcare services, nor pharmaceutical coverage. When a U.S. health citizen reaches the age of 65, they are then covered for the Medicare Part D drug benefit.

The chart, based on the Fund’s survey data, illustrates that the U.S. had the highest level of Rx non-adherence in 2014, followed by Canada.

The bottom-line, the authors write: “CRNA is inversely related to the extent of drug coverage available.”

Health Populi’s Hot Points: Consumer-directed health plans in the U.S. are designed to give consumers more financial “skin-in-the-game.” The theory behind CDHPs is that having a financial stake in health care decisions will incentivize and motivate patients to behave as consumers who shop for healthcare services and products.

When it comes to prescription drugs, there is a level of transparency at the point-of-purchase, in the form of a price paid at the pharmacy, or for mail-order medicines that address peoples’ chronic conditions. There are apps like GoodRx that help people find the best price for a particular drug in their community (or for a generic equivalent), and even drive a digital coupon to that patients’ smartphone for a discount on the retail price of the drug.

The BMJ Open study reveals that, by 2014, consumers 55 and over were still not behaving in ways that were clinically responsible. Some portion of 16.3% of health citizens in American were self-rationing prescribed drugs due to cost, going against their doctors’ (or prescribers’) recommendation because of money.

This was more a jobs message than a cost-control message. The President didn’t use the “M” word in this meeting as he did in his interview as TIME magazine’s Person of the Year, claiming these same companies were committing “murder” due to their Rx pricing strategies. He did not push the concept of directly negotiating with the companies for products covering Medicare and Medicaid, a strategy that was included in his campaign platform before being elected President.

The evening of this meeting, I saw, for the first time, a broadcast commercial during the six o’clock news hour on cable TV, featuring PhRMA’s new ad campaign to promote the pharma industry’s role in making consumers’ lives better by not going gently into that good night. It’s a beautifully-produced launch. Here’s the video.

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Jane will brainstorm the future of health at the intersection of health care and technology with Lisa Suennen, Venture Valkyrie and Leader of Manhattan Digital and Technology Group, and Dr. Geeta Nayyar, prominent physician and nationally recognized leader in health care and technology, at AHIP’s annual Institute and Expo - virtual, on June 18th at 9 am.

The Consumer Technology Association (CTA) created a wonderful summary of CES 2020 in Las Vegas, which feels like nostalgic today in the wake of the COVID-19 pandemic. Here's a link to the story, and at the bottom, a sweet reminder of my fellow authors and me, all featured in Gary's Book Club for #CES2020. Happy memory!

Jane will be donvene virtually with telehealth stakeholders to bolster the health care consumer message and opportunities at the ATA annual meeting that's -- appropriately! -- going online this year in the COVID-19 era.

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